Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

Abstract

Introduction: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners. Methods: CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. Results: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. Conclusion: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

The proportion of HIV disclosure to sexual partners among people diagnosed with HIV in China: A systematic review and meta-analysis

“…Our findings support previous studies conducted in Togo ( 93 ) and Uganda ( 94 ). On the contrary, our HIV disclosure rate was lower than in the United States ( 95 ), and some African countries, such as Kenya ( 96 ), South Africa ( 97 ), Ethiopia ( 31 ).…”

“…They focused on influencing factors of HIV disclosure ( 14 , 20 – 22 ), disclosure policies and their effectiveness ( 13 , 23 , 24 ), interventions for HIV disclosure ( 25 , 26 ), evaluation of self-report disclosure tools ( 27 ), and the HIV disclosure among specific populations such as adolescents or immigrants ( 28 – 30 ). Four reviews synthesized the proportions of HIV partner disclosure among Ethiopian adults with PDWH ( 31 – 34 ). One ( 31 ) reported 76.03% of pooled disclosure rate (18 studies, 8,009 participants), while the other ( 32 ) reported 73% of disclosure rate (12 studies, 4,528 participants).…”

“…Four reviews synthesized the proportions of HIV partner disclosure among Ethiopian adults with PDWH ( 31 – 34 ). One ( 31 ) reported 76.03% of pooled disclosure rate (18 studies, 8,009 participants), while the other ( 32 ) reported 73% of disclosure rate (12 studies, 4,528 participants). Two other reviews ( 33 , 34 ) reported 74.63% (22 studies, 8,873 participants) and 75.95% (18 studies, 7,084 participants) disclosure proportions, respectively.…”

“…Two other reviews ( 33 , 34 ) reported 74.63% (22 studies, 8,873 participants) and 75.95% (18 studies, 7,084 participants) disclosure proportions, respectively. However, there is still a lack of knowledge about the special characteristics of HIV disclosure to sexual partners ( 31 – 34 ). The quality of the reviews was also low, resulting in high publication bias ( 32 , 34 ).…”

Knowledge of Sexually Transmitted Infections and HIV among People Living with HIV: Should We Be Concerned?

“…However, the fear of being avoided and judged is still highly reported. A similar prevalence was reported by Endalamaw et al in Ethiopia (76%) [28], while a lower rate of disclosure resulted from a systematic review conducted in China (65%) [29]; however, both studies considered disclosure to sexual partners only and come from very different contexts [28,29]. An observational study conducted in 2012 and 2013 aiming to assess disclosure attitudes and predictors among women living with HIV reported a high prevalence of disclosure (1724/1929, 89%); women from Western Europe showed better attitudes towards disclosure, data that we hope has improved since the spreading of the U=U campaign [30].…”